Ebola in Africa and the U.S.: A Curation

I’ve stayed out of the Ebola news so far, for a couple of reasons. First, as longtime readers know, I’m writing a book; I’m in the last 6 months of it and the work is intense and involves a lot of travel. I’m not always available at the exact moment news breaks. Second, I try to explore things here that readers may not have heard about elsewhere. The Ebola outbreak has been building in West Africa for a while, but when it was revealed at the end of last week that two American aid workers had caught the disease — and that they were being transported back to the US for treatment — the news and the reaction to it instantly filled every channel. Over the weekend, so much misinformation and outrage got pumped out that it feels as though there’s no way to cut through the noise.

But I have a few thoughts. Start with this: No, I don’t think the two aid workers who are being returned to the US pose any risk at all to the average American, or even the average Atlanta resident. Here’s my marker on that: I’m an Atlanta resident. I live less than 2 miles from the CDC and Emory University (the aid workers are being treated in a special unit housed at Emory on behalf of the CDC; the two institutions are next door to each other). My entire neighborhood and a good part of my various friendship circles are CDC employees, Emory healthcare workers, or both.

(My further marker on this, as longtime readers also know, is that I spent 10 years as a newspaper reporter covering the CDC full-time. I talked my way into outbreak investigations on most of the continents, and embedded with the CDC’s disease-detective corps for a year and wrote a book about it. I am by no means a CDC booster, but I have been with CDC personnel when they made careful, thoughtful decisions about unfamiliar disease risks, including in the anthrax attack on Capitol Hill and during SARS. The recent anthrax lab incident, which was regrettable and sloppy, doesn’t change my mind.)

I base my confidence about the lack of risk to the US in part on the biological reality that Ebola is fundamentally a difficult disease to catch. Contracting it requires direct contact with the bodily fluids — blood, feces, vomit — of someone who is symptomatic with the disease. You cannot catch Ebola from someone who is incubating it but not symptomatic; and you cannot catch it from simply being in the same room as someone who has it. (If you’re going to quote back to me the infamous “airborne Ebola” paper from 2012, don’t bother. Six pigs, four monkeys, engineered lab conditions: no relevance to any real-world situation in a household or a hospital.)

That I am anti-Ebola panic — and especially anti-Ebola media scrum, which was disgraceful — does not mean I am not concerned about Ebola where it is authentically a problem, which is in the expanding epidemic in West Africa. It is a dreadful outbreak, it needs attention, and it says something ugly about us as a society that we only really noticed it when two Westerners were injured by it. But, again: The conditions that are pushing that epidemic along do not exist in the US.

Having said all that, here are a few pieces that I think would be worth your time to read.

Also, in case you missed it the first time: Me, here at Superbug, on the eight known times that a patient with viral hemorrhagic fever has come to the US, without the disease ever once spreading to someone else.

This is probably all I’ll have to say on the Ebola situation for a while — unless something changes (or something else gravely annoys me) — so I just want to end by showcasing the comments of the Emory University Hospital leadership on treating the two aid workers. This was sent to Emory staff Sunday afternoon and subsequently posted publicly. It portrays an attitude that I wish we could all adopt as this situation moves forward:

There has been much discussion about bringing patients with Ebola back into our country. Emory University Hospital physicians, nurses and staff can treat them safely and effectively, and we are honored to have the privilege of caring for these patients who contracted Ebola while serving on a humanitarian mission. These two Americans want to come back home and be treated here, and we are committed to helping them. It is our moral obligation to always use our expertise, training, knowledge and gifts to provide such extraordinary care for others.